Elevation of the Malar Fat Pad With a Percutaneous Technique

Abstract

To describe a simplified method of malar fat pad elevation to rejuvenate the midface, nasolabial folds, labiomental folds, infraorbital hollows, and jowls via a percutaneous approach.Patients and Design: One hundred eighteen patients were evaluated over a 12-month period in a prospective fashion by the operating surgeon. Preoperative and postoperative photographs were used for comparison.Setting: Private practice.Main Outcome Measures: Elevation of the malar fat pad by a measured amount.Results: At 3 months, all patients had a significant elevation of the malar fat pad (3-7 mm), with the exception of 2 early patients who underwent revision surgery, with satisfactory results.Conclusions: A simplified method of malar fat pad elevation is described. This method allows for elevation of the malar fat pad without extensive dissection. Excellent results are obtained with very little morbidity.

Novel Face-Lift Suspension Suture and Inserting Instrument: Use of Large Anchors Knotted into a Suture with Attached Needle and Inserting Device Allowing for Single Entry Point Placement of Suspension Suture. Preliminary Report of 20 Cases with 6- to 12-M

“…2 Keller and colleagues described a relatively simple looping suture for the nasolabial fold area. 3 Multiple looping sutures placed at various points in the face have been recently described by Weinstein,4 but lacked evidence of follow-up beyond the immediate or very short-term postoperative period. The inherent problem of looping, or cable type suspension suture, is the long distance between the two points of tension.…”

Clinical evaluation of non-ablative radiofrequency facial rejuvenation

“…This is consistent with what would be expected with the percutaneous midface lift procedure as practiced during the time of this study, since lateral brow arcus marginalis attachments and precanthal ligaments were routinely released, and the temporoparietal fascia was elevated and anchored superiorly and laterally to the deep temporalis fascia. 11 All surgical procedures performed concurrently with RF facial treatment were minimally invasive, and involved either minimal elevation of skin flaps or hearty bipedicled skin flaps (in the case of the three patients who had neck liposuction or lift). Since the RF energy penetrates to the deep dermis and subcutaneous tissue, and could potentially compromise the subdermal plexus, extensive undermining of cutaneous flaps at the time of RF treatment should be undertaken with great caution, especially in smokers and those with collagen-microvascular disease, who may already A B have a tenuous blood supply to the skin.…”

Is there an ideal facelift procedure?

“…Keller et al [26] modified the technique of Sasaki and Cohen, creating a tunnel from the temporal incision along the deep temporal fascia using an elevator. Keller used a Prolene suspension suture in 118 patients, 98.3% of whom maintained significant elevation at 1 year.…”